Abstract
e15595 Background: Current guidelines recommend cessation of average risk colorectal cancer screening at age 75, after which a more individualized approach is endorsed. There is limited data on characteristics of colorectal cancer in patients over the age of 75. We aimed to determine if colorectal cancer site and metastasis is greater in the community vs academic setting in patients aged 50-75 compared to those age 75 or older. Methods: Data were analyzed from the National Cancer Database (NCDB) between 2010-2014. Results were divided into two categories (50-75 year old, >75 year old) and included number of patients, site of cancer and site of metastasis. Patient characteristics and survival were compared with Mann-Whitney U, Pearson’s Chi-square, and the Kaplan-Meier method. Results: 167, 059 patients were included in the analysis. In the academic setting, group A (age 50-75) contained 36, 298 patients and group B (>75) contained 13,253 patients. In the community setting, group A involved 77, 657 patients and group B, 39,851 patients. In the academic setting, group A identified 57.7% of cases involving the colon vs 42.3% involving the rectum. In group B, 71.4% cases involved the colon vs 28.6% involving the rectum. In the community setting, group A identified 64.4% of cases involving the colon compared to 35.6% involving the rectum. For group B, 76.2% of cases diagnosed were in the colon vs. 23.8% of cases involving the rectum. Overall, indicating a statistically significant increase seen in colon involvement in the older age group (<0.001). In community and academic practice, there is a statistically significant increase in the cases involving metastasis for group A, compared to group B (p<0.001) This is seen for specific sites as well, including bone, liver and lung, (p< 0.001) but not brain involvement in academic practice. Conclusions: In this study, we found a statistically greater number of cases of involving metastasis in patients aged 50-75 compared to patients aged 75 and older in both academic and community practices. In both the academic and community setting, older patients demonstrated statistically greater involvement of the colon compared to patients aged 50-75. Overall, there were more cases of colon and rectal cancer for both age groups seen in the community setting compared to the academic setting.
Published Version
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